目的:探讨噬血细胞淋巴组织细胞增生症(HLH)伴中枢神经系统(CNS)累及患儿临床特征及预后危险因素,为进一步改善患儿预后提供更多参考。方法:回顾性分析本院2006年1月-2016年10月收治HLH伴CNS累及的45例患儿临床资料,记录患儿临床特征,...目的:探讨噬血细胞淋巴组织细胞增生症(HLH)伴中枢神经系统(CNS)累及患儿临床特征及预后危险因素,为进一步改善患儿预后提供更多参考。方法:回顾性分析本院2006年1月-2016年10月收治HLH伴CNS累及的45例患儿临床资料,记录患儿临床特征,针对可能影响患儿预后危险因素建立Cox风险比例模型进行单因素和多因素分析。结果:45例患儿中男19例,女26例,中位年龄为4.0(1-15.1)岁,其中EBV感染38例(84.44%),CMV感染1例(2.22%),细菌感染3例(6.67%),结缔组织疾病1例(2.22%),无明确病因2例(4.44%)。27例行腰椎穿刺检查后证实脑脊液异常10例(37.04%);45例患儿中头颅影像学检查异常22例(48.89%)。45例患儿随访1年总生存率为46.67%(21/45),随访3年总生存率为44.44%(20/45),中位生存时间为5.0个月。脑脊液异常患儿随访1年总生存率显著低于脑脊液正常患儿(10 vs 17例)(P<0.05)。未行鞘内注射患儿随访1年总生存显著低于行鞘内注射患儿(10 vs 17例)(P<0.05)。单因素分析显示,神经系统症状、脑脊液异常、未行鞘内注射及治疗方式均是影响HLH伴CNS累及的患儿预后危险因素(P<0.05)。以上变量引入Cox风险模型行多因素分析显示,脑脊液异常和未行鞘内注射是HLH伴CNS累及的患儿预后独立危险因素(P<0.05)。结论:HLH伴CNS累及的患儿临床预后相对较差,部分患儿后遗神经系统病变;而脑脊液异常和未行鞘注治疗是导致患儿临床预后不良的独立危险因素。展开更多
To study the mechanism of unsteady heat-moisture transfer of wet surrounding rock in deep mining, a series of experiments with different initial and boundary conditions were carried out. Test results show that rock te...To study the mechanism of unsteady heat-moisture transfer of wet surrounding rock in deep mining, a series of experiments with different initial and boundary conditions were carried out. Test results show that rock temperature decreases quickly at the initial stage, and reduces slowly to be a constant value finally for transient heat-moisture transfer. The quasi-steady surface temperature of wet airway is lower than that of dry airway due to the moisture transfer. The diffusion radius is less than the cooling radius owing to the large diffusion resistance. The outlet airflow enthalpy of wet airway is much larger than that of dry airway. Latent heat caused by the moisture transfer plays a significant role in a deep thermal environment. For periodic heat-moisture transfer, temperature, humidity and enthalpy of outlet airflow and rock temperature also change periodically. The wave amplitude of rock temperature decreases gradually with increasing distance away from the airway surface, and the wave phase of rock temperature is also behind that of airflow. Moreover, direction of the heat-moisture transfer between airway and airflow is bidirectional, which is different from results of transient transfer.展开更多
文摘目的:探讨噬血细胞淋巴组织细胞增生症(HLH)伴中枢神经系统(CNS)累及患儿临床特征及预后危险因素,为进一步改善患儿预后提供更多参考。方法:回顾性分析本院2006年1月-2016年10月收治HLH伴CNS累及的45例患儿临床资料,记录患儿临床特征,针对可能影响患儿预后危险因素建立Cox风险比例模型进行单因素和多因素分析。结果:45例患儿中男19例,女26例,中位年龄为4.0(1-15.1)岁,其中EBV感染38例(84.44%),CMV感染1例(2.22%),细菌感染3例(6.67%),结缔组织疾病1例(2.22%),无明确病因2例(4.44%)。27例行腰椎穿刺检查后证实脑脊液异常10例(37.04%);45例患儿中头颅影像学检查异常22例(48.89%)。45例患儿随访1年总生存率为46.67%(21/45),随访3年总生存率为44.44%(20/45),中位生存时间为5.0个月。脑脊液异常患儿随访1年总生存率显著低于脑脊液正常患儿(10 vs 17例)(P<0.05)。未行鞘内注射患儿随访1年总生存显著低于行鞘内注射患儿(10 vs 17例)(P<0.05)。单因素分析显示,神经系统症状、脑脊液异常、未行鞘内注射及治疗方式均是影响HLH伴CNS累及的患儿预后危险因素(P<0.05)。以上变量引入Cox风险模型行多因素分析显示,脑脊液异常和未行鞘内注射是HLH伴CNS累及的患儿预后独立危险因素(P<0.05)。结论:HLH伴CNS累及的患儿临床预后相对较差,部分患儿后遗神经系统病变;而脑脊液异常和未行鞘注治疗是导致患儿临床预后不良的独立危险因素。
基金Foundation item： Project（2012CB026103） supported by the National Basic Research Program of China Project（51204170） supported by the National Natural Science Foundation of China+2 种基金 Project（2011M500974） supported by Postdoctoral Science Foundation of China Project （2011QNA16） supported by Fundamental Research Funds for the Central Universities, China Project（PDll01） supported by Postdoctoral Foundation of State Key Laboratory for Geomechanics and Deep Underground Engineering, China
文摘To study the mechanism of unsteady heat-moisture transfer of wet surrounding rock in deep mining, a series of experiments with different initial and boundary conditions were carried out. Test results show that rock temperature decreases quickly at the initial stage, and reduces slowly to be a constant value finally for transient heat-moisture transfer. The quasi-steady surface temperature of wet airway is lower than that of dry airway due to the moisture transfer. The diffusion radius is less than the cooling radius owing to the large diffusion resistance. The outlet airflow enthalpy of wet airway is much larger than that of dry airway. Latent heat caused by the moisture transfer plays a significant role in a deep thermal environment. For periodic heat-moisture transfer, temperature, humidity and enthalpy of outlet airflow and rock temperature also change periodically. The wave amplitude of rock temperature decreases gradually with increasing distance away from the airway surface, and the wave phase of rock temperature is also behind that of airflow. Moreover, direction of the heat-moisture transfer between airway and airflow is bidirectional, which is different from results of transient transfer.
